Abstract 19813: Sleep Disturbance, Heart Failure, and Cognitive Function in Older Individuals: The Aging Demographics, and Memory Study (ADAMS)

Abstract

Introduction: Approximately 50% of heart failure (HF) patients experience cognitive decline. In the general population, sleep disturbance is associated with cognitive decline. Sleep disturbance may alter the cellular or chemical homeostasis triggering cognitive decline. Up to 70% of individuals with HF report sleep disturbance. Although the etiology of cognitive decline in HF is unknown, sleep fragmentation and short sleep duration from sleep disturbance may partially explain cognitive decline among individuals with HF. This study investigates the possible mediating role of sleep disturbance on the relationship between HF and cognition. Methods: This cross-sectional study examined 856 older adults’ (mean age: 81.6 years, SD: 7.1, male: 355 (41%), Caucasian: 658 (77 %), HF: 100 (11.7%)) data from Aging, Demographics, and Memory Study. To explore the possibility of meditating effects of sleep disturbance on relationship between HF and cognition, we used a structural equation model. Cognition was measured by neuropyshological tests. Sleep disturbance was determined if a subject was positive on one of the following three questions: 1) “Do you have problem falling asleep?”, 2) “Do you wake frequently during sleep?”, and 3) “Do you wake up too early?” Results: Individuals with HF were likely to have a higher degree of sleep disturbance (β=0.229,p=0.003). Sleep disturbance was a significant predictor of cognitive decline (β=-6.52,p=0.028). However, there was no significant mediating effect of sleep disturbance on the relationship between HF and cognition (β=-0.011,p=0.978) after controlling for age, sex, and comorbidities. Conclusion: Findings from this study suggest that HF can exacerbate sleep disturbance and sleep disturbance can deteriorate cognition. However, the mediating role of sleep disturbance on the relationship between HF and cognitive decline remains questionable. Future studies using objective measures and longitudinal design would enhance our knowledge related to the relationship between heart failure, sleep disturbance, and cognition.